More alike than different?

At the 10th annual European session of the Global Health Leadership Forum’s executive programme, recently held here at The King’s Fund, I was reminded of a saying attributed to a West African health professional: ‘Learning about culture is like learning a language. The same words often mean different things. What does family mean? Responsibility? Respect? What does pain mean? What is a good life? These ideas probably exist in all cultures but they are not always thought of or expressed in the same way.’

As we met on Day one to discuss integrated care it was quickly apparent that this term meant different things for health care in South Africa, Singapore, Saudi Arabia, Peru and the UK to name just five of the eighteen countries represented this year. We helped participants to represent their diverse perspectives visually, creating a panel focused on the term ‘no wrong door for the patient.’ The visual representation was seen by many as a key highlight of the programme, and participants acknowledged the role they have as leaders in working within their local resources and diverse contexts.

As the programme progressed, the participants, stimulated by a range of presentations, discussed and challenged the differences and similarities in their understanding of other themes such as mental health and dementia, innovation in health, contracting and payment methods and wellness. Through field trips and sharing information on individual projects, this community of leaders made a paradigm shift from some traditional views that ‘West is best’ to understanding that they can co-create solutions, taking the best from developed economies as well as learning from the innovation found in emerging economies.

As one participant, Murray Ross, explored the impact that President Obama’s attempt to get his health reforms through was having on the imminent US elections, participants were reminded of the impact politics has on the provision of health. One of the group’s collective wishes was for politicians to show leadership in letting positive health care reforms (irrespective of genesis) the time they need to deliver improvements and to stop unleashing new programmes with each successive political changeover.

The event was a timely reminder of the contrast between the ‘entitlement culture’ that can operate in developed economies – including our own NHS – and the ‘working within the limits of our means’ that countries such as Brazil, Kenya and India bring to meeting global health challenges.

One thing that united all participants was a belief that great leadership was needed to meet the global health challenges of the next 10 years. In concluding comments, participants said that the Forum had helped them think of ‘ideas to improve health care’. We hope that this dialogue will continue to progress in line with The King’s Fund’s mission ‘ideas that change health care.’ We have a lot to learn from each other.

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#2076 sheree axon
System transition director

I love the idea of 'no wrong door for any patient'...this is a great aspiration to have at a time of great change.

#2098 Joy Lewis
Kaiser Permanente

The week was well spent diving into topics such as integration, innovation, rising health care costs, among others. There was reinforcement that we are all solving to very similar problems globally. Participants remained actively engaged in the learning and sharing process over the course of the week. There were new ideas generated, new ways of thinking about existing problems and recommendations for next steps. Overall, time well spent!!

#2119 Vijaya Nath
Assistant Director, leadership
The King's Fund

Thank you Sheree, good to know that leaders from diverse economies can agree that the patient is first. I hope that the message from GHLF is retained in our own NHS, Patients central to what we do!

#2127 Kim Faure
Healthcare consultant
Pure Health Consulting

The powerful insight for me was that people from the developing world can offer solutions to problems that developed worlds easily overlook. Often we over complicate a solution when we should maybe have the thought that we work within our limits. extra funding is not always the solution - thinking differently and out of box maybe it.
A very powerful program!

#2194 Ruth Taylor
Associate Head of School (nursing and midwifery)
Robert Gordon University Aberdeen

Interesting to read the blog and subsequent comments. I am about to go to Malawi as part of a project relating to midwives in rural Malawi. We aim to co-produce the project as it develops - not to impose our western approach. I am absolutely sure that there will be learning across organisations and cultures and I will be bringing my learning back to the students in my university. What I do know is that the UK and Malawi project team members share a common purpose - making a difference to the women, babies and families - the person at the centre. My blog (nurseeducationrt) will report on my reflections and others' thoughts will be helpful.

#2239 Vijaya Nath
Assistant Director, Leadership
The King's Fund

Professor Taylor thank you for taking time to contribute to this.We would be interested in hearing from you post Malawi and looking at how we continue to spread inter cultural expertise.

#2299 Leighton McDonald
Chief Executive Officer

This week, spent analysing potential solutions to some of healthcare's critical issues, was a great follow up to the GHLF session held in Berkeley earlier this year. A common theme was the ongoing increase in need for healthcare services and products as a result of an ageing population, medical advances and increased expectations. Healthcare delivery systems will need to be restructured to allow for sustainable provision of services at an appropriate level. More focus on illness prevention, early detection and management of illness as well as on primary health is needed. The fact that this extends beyond the healthcare industry and into the community environment should be emphasised.

#2313 Julian Brookes
Assoiciate Director Policy and Business Planning
NHS South of England

Interesting comments and views. I feel disapointed at not being part of what must have been an excellent event.

I have been lucky enough in the past to be involved in a number of international collaborations. I believe we often ingnore the lessons from around the world and in particular the developing countries.

Adversity breeds innovation. When money cannot be thrown at a problem other solutions are found. These can be remarkable.

I remember how impressive the approach of Cuba was to Primary Care when I visited 10 years ago. It was first time I had seen the polyclinic approach.

But I am also reminded of the powerful link between politics and healthcare systems. In many ways a helathcare system is a window into the psyche of a nation. Its my belief that this is the reason that healthcare is such a powerful political tool.

I believe that innovation in other health systems needs to be looked at in terms of the drivers that supported its creation. These are often both politcial and social. This in turn means that lifting innovation from one system to another is not the simple matter of replication - co-production is the way forward both in terms of introduction into the NHS and sharing success from the NHS with international partners.

#25977 Bruce
State Medical Director
DonateLife WA

Really interesting stuff thank you.

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